Provider Demographics
NPI:1548313687
Name:CAREW, JOHN LAWRENCE (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LAWRENCE
Last Name:CAREW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SAGAMORE TRL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1306
Mailing Address - Country:US
Mailing Address - Phone:978-486-8105
Mailing Address - Fax:978-486-1044
Practice Address - Street 1:15 SAGAMORE TRL
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1306
Practice Address - Country:US
Practice Address - Phone:978-486-8105
Practice Address - Fax:978-486-1044
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3609103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS002468OtherOLD CHAMPUS #
MA3609OtherMA PSYCHOL HP LICENSE
MA35667OtherNATLREGHP INPSYCHOLOGY
MAWO3633OtherBCBS MA PROVIDER #
MA35667OtherNATLREGHP INPSYCHOLOGY